Thank you, Madam Chair.
Good morning, everyone. I would like to thank the committee for giving us this opportunity to speak about innovative health care practices.
We are a team. I am a professor and the holder of the Research Chair in innovative nursing practices in the faculty of nursing at the Université de Montréal, and a researcher at the CHUM research centre. My colleague Diane Saulnier, who is also a nurse, is the coordinator of the Chair for the research program.
In the next 10 minutes, I am going to touch on the main points in the brief on innovative health care practices that was submitted, and of which you have the English and French versions in front of you.
What am I referring to when I talk about innovative health care practices? These are information and communications technology or ICT-assisted health care interventions for chronic illness.
Why for chronic illness? Because offering health care and services designed to support this clientele better is a major challenge for our health care system. In Canada, 65% of the population 12 years of age and over reports suffering from at least one chronic health problem. This is a major challenge.
Living day-to-day with a chronic health care problem involves detecting signs and symptoms of worsening. It also involves managing day-to-day therapy, managing treatment, and applying healthy behaviours. We talk a lot about how the person needs to be learn self-management behaviours. The illness is experienced not in hospital, but in the home. It is an irreversible illness; a life-long illness. People need to be better equipped and better supported.
This explains the use of the innovative practices that ICTs offer. ICTs enable us to reach people in their home using new methods, new approaches for health care interventions.
Because I am a researcher, I have seen the extent to which this research niche has expanded over the last 10 years. We have developed many interventions in ICT-assisted health care. The current state of our knowledge means that we can really appreciate these innovative practices. The results are genuinely promising in terms of improving these individuals' capacity for self-management, healthy behaviours and adherence. For example, we have observed certain health indicators among patients with diabetes, including better blood glucose control.
These interventions really represent promising avenues. They have been mainly evaluated with patients with cardiac disease, diabetes or chronic obstructive lung disease. If you look into these ICT-assisted health care interventions more deeply, you will see that there is really a spectrum, a wide variety, ranging from a website that offers very broad informational content and minimal assistance, to more sophisticated intervention. For example, there are programs that help the individuals affected to acquire skills or offer them on-line support in real time with a health care professional. There is really a whole spectrum of services.
At present, the state of the knowledge is not sufficient that we can present an accurate picture of what works best, with whom, and in what situations. We are therefore continuing the research in order to expand these innovations and evaluate them, but also to assess their cost-benefit ratio.
It is in the context of this trend toward chronic illness being managed at home, rather than in hospital, that our research chair has developed a virtual nursing intervention concept. We have distributed the portfolio to you. It will give you a little more information. Because I am allotted only 10 minutes, I will not go into the details.
There are no longer any geographical limits on the health care provided, particularly to patients living with a chronic health problem. Given that fact, we have developed TAVIE, the French acronym for treatment, virtual nursing assistance and teaching. These are virtual nursing interventions that target the capacities of the people affected to act and equip them to self-manage their health condition.
That goes beyond a website that conveys information, because information never leads to behavioural change. We work more on people's skills.
The first application we developed is VIH-TAVIE, to help patients living with HIV manage their antiretroviral medications better. These patients, who have HIV, meet with their health care team three or four times a year. However, these patients need real-time support, and that is what we offer with our VIH-TAVIE.
This involves interactive computer sessions, where the person is invited to get involved in a skills development process with a virtual nurse. It is done asynchronously. Everything was thought out and simulated in advance, and so it does not call for additional resources, strictly speaking.
The nurse gives advice tailored to the person, based on the person's answers to the questions asked and the needs they are experiencing. We might say that these are more sophisticated programs where personalized interventions are targeted at capacities. How do we see it?